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July 11, 2012

Lipid Parameters and Cardiovascular Events in Patients Taking Statins—Reply

Author Affiliations

Author Affiliations: Departments of Cardiology (Dr Boekholdt) and Vascular Medicine (Dr Kastelein; j.j.kastelein@amc.uva.nl), Academic Medical Center, Amsterdam, the Netherlands.

JAMA. 2012;308(2):131-133. doi:10.1001/jama.2012.6632

In Reply: Drs Martin and Jones agree with us that individuals reaching their LDL-C target but not their non–HDL-C target are at increased cardiovascular risk, whereas the opposite was not the case. They requested 2 additional analyses. People reaching the LDL-C target of 70 mg/dL but not the non–HDL-C target of 100 mg/dL were not at increased cardiovascular risk (HR, 1.05; 95% CI, 0.88-1.26) compared with those reaching both targets. The same is true for those reaching the non–HDL-C but not the LDL-C target (HR, 0.93; 95% CI, 0.82-1.05). A similar analysis using the LDL-C target of 100 mg/dL and the apoB target of 80 mg/dL, as suggested by Contois et al,1 yielded slightly different results. Those reaching the LDL-C but not the apoB target were at increased cardiovascular risk (HR, 1.13; 95% CI, 1.05-1.22). People reaching the apoB but not the LDL-C target had a slightly higher HR of 1.18 (95% CI, 0.96-1.45), but this estimate did not reach statistical significance due to a low number of events.